Purpose: Short dental implants are usually placed to avoid vertical augmentations. However, surgical experience appears to be fundamental, especially in compromised bone qualities. This study aimed to evaluate the importance of clinical expertise on implant stability (IS) of 6mm implants placed in vitro. Materials and Methods: 480 implants (BioHorizons®-Tapered, 6mm with diameters 4.6mm and 5.8mm) were utilized. All implants were placed by three clinicians with different surgical experience levels. One master clinician (A); one third-year resident with experience near 100 implants (B); and one resident without implant surgical experience (C). Each surgeon prepared 40 osteotomies for each implant diameter in type I bone and 40 osteotomies in type IV-bone quality (Sawbones®), respectively. In each group, 20 implants were placed at crestal bone level, the other 20 implants 1mm supracrestal. The IS was evaluated using an Osstell®-device. Comparison of IS between the A, B, and C for all implant groups was performed using ANOVA and Bonferroni correction for multiple comparisons for significance level as p<0.05. Results: Implants placed supracrestally showed differences between the experienced clinicians vs. the inexperienced, but not between the master clinician and 3rd-year resident. A similar trend can be observed with implants placed at crestal levels. In type I-bone, greater stability was achieved for the experienced clinicians when compared to the inexperienced (p<0.0001); however, in type IV bone, the comparison of stability showed p <0.0001 for all groups, with greater IS values for master clinician over both residents. Conclusions: Overall, both master and moderate experienced surgeons presented increased stability on 6mm implants compared to the inexperienced resident.
Keywords: implant stability, short implants, subcrestal implant placement
